Povidone-lodine Strikes Back-Reply

In Reply.—Unfortunately, Drs Zamora and Feldtman continue to equate any iodophor with unquestioned antimicrobial activity. The activity of iodophors is dependent on the level of free iodine. Diluting iodophor solutions increases their level of free iodine and improves their activity.¹ In their undiluted form, iodophors may be so ineffective that the solutions can become and remain contaminated. Recently, several commercially available iodophors were found to be contaminated with bacteria on opening.² In a previous study with our wound infection model, Custer et al³ showed that exposure of a single group of contaminated wounds to iodophor antiseptic solution resulted in less wounds containing pus after four days than similarly contaminated wounds treated with saline. However, all wounds yielded positive cultures. Subsequent improvements in analysis techniques proved that quantitative bacteriologic assessment more accurately reflected the true status of the wound than did the presence or absence of pus.